Health Care in the United States: Organization, Management, and Policy

Health Care in the United States: Organization, Management, and Policy......Page 3
CONTENTS......Page 5
TABLES AND FIGURES......Page 9
PREFACE......Page 13
THE AUTHOR......Page 17
ACKNOWLEDGMENTS......Page 18
PART 1: THE SYSTEM AND ITS TASKS......Page 19
LEARNING OBJECTIVES......Page 21
HEALTH CARE AS A NATIONAL CONCERN......Page 22
HEALTH CARE OBJECTIVES AND GOALS......Page 26
ESSENTIAL CHALLENGES IN HEALTH CARE......Page 27
PUBLIC TRUST AND PROFESSIONAL ETHICS......Page 31
THREE PERSPECTIVES ON MANAGEMENT AND POLICY......Page 33
KEY TERMS......Page 35
DISCUSSION QUESTIONS......Page 36
LEARNING OBJECTIVES......Page 37
UNIQUENESS OF THE SYSTEM......Page 38
AMERICAN VALUES AND HEALTH CARE......Page 47
CONTROVERSIES IN U.S. HEALTH CARE......Page 53
SUMMARY......Page 56
DISCUSSION QUESTIONS......Page 57
LEARNING OBJECTIVES......Page 59
CONCEPTIONS OF HEALTH AND DISEASE......Page 60
THE CAUSES OF DISEASE......Page 67
NONDISEASE THREATS TO HEALTH, FUNCTION, AND SURVIVAL......Page 73
EPIDEMIOLOGY: THE SCIENCE OF THE DENOMINATOR......Page 74
HEALTH AND ILLNESS IN THE TWENTY-FIRST CENTURY......Page 80
FUTURE THREATS TO HEALTH......Page 86
SUMMARY......Page 87
DISCUSSION QUESTIONS......Page 88
LEARNING OBJECTIVES......Page 89
THE CONCEPT OF THE SICK ROLE......Page 90
HEALTH RISK BEHAVIOR......Page 91
USE OF HEALTH SERVICES......Page 101
ADVERSE PATIENT BEHAVIOR......Page 106
HEALTH LITERACY AND CULTURAL COMPETENCE......Page 108
COMPLEMENTARY AND ALTERNATIVE MEDICINE......Page 112
CONSUMER PREFERENCES AND HEALTH CARE MARKETING......Page 115
SUMMARY......Page 116
DISCUSSION QUESTIONS......Page 117
PART 2: MEANS OF DELIVERY......Page 119
LEARNING OBJECTIVES......Page 121
THE IMPORTANCE OF ORGANIZATIONS IN HEALTH CARE......Page 122
HEALTH SERVICE INDUSTRY SECTORS......Page 123
AMBULATORY CARE ORGANIZATIONS......Page 128
THE HOSPITAL......Page 134
THE MANAGED CARE ORGANIZATION......Page 146
OTHER HEALTH CARE ORGANIZATIONS......Page 148
ORGANIZATIONAL MANAGEMENT IN HEALTH CARE......Page 153
SUMMARY......Page 154
DISCUSSION QUESTIONS......Page 155
LEARNING OBJECTIVES......Page 157
HEALTH CARE LABOR FORCE ISSUES......Page 158
THE CONCEPT OF PROFESSIONALISM......Page 159
HISTORY, BACKGROUND, AND CHALLENGES IN THREE KEY FIELDS......Page 161
CLINICIANS AS MANAGERS......Page 172
THE HEALTH CARE LABOR FORCE: FACTS AND FIGURES......Page 173
LABOR FORCE DYNAMICS IN THE HEALTH PROFESSIONS......Page 178
PROFESSIONAL ETHICS, OVERSIGHT, AND DISCIPLINE......Page 183
SUMMARY......Page 187
DISCUSSION QUESTIONS......Page 188
LEARNING OBJECTIVES......Page 189
HEALTH SERVICE FUNDING AND EXPENDITURES......Page 190
HEALTH CARE COSTS: A GLOBAL ISSUE......Page 191
COST ACCELERATORS IN THE UNITED STATES......Page 193
HEALTH INSURANCE......Page 196
ADDITIONAL INSURANCE CONCEPTS AND TERMINOLOGY......Page 210
MEDICARE SPECIFICS AND ISSUES......Page 212
THE PROBLEM OF UNINSURANCE......Page 215
CONTINUING ISSUES......Page 219
DISCUSSION QUESTIONS......Page 223
LEARNING OBJECTIVES......Page 225
THE IMPORTANCE OF RESEARCH......Page 226
PRINCIPLES OF EXPERIMENTAL DESIGN......Page 227
MODERN RESEARCH DESIGNS......Page 229
PROGRAM EVALUATION......Page 236
THE SOCIAL AND ECONOMIC CONTEXT OF RESEARCH......Page 239
SCIENCE GONE WRONG: ERROR, DISTORTION, AND FRAUD......Page 244
SUMMARY......Page 247
DISCUSSION QUESTIONS......Page 248
PART 3: PATHS FORWARD......Page 249
LEARNING OBJECTIVES......Page 251
HEALTH SERVICE INNOVATIONS: STRATEGIC AND TACTICAL......Page 252
INNOVATIONS AND HEALTH SERVICE OBJECTIVES......Page 253
OUTCOMES OF STRATEGIC INNOVATION I: SELECTIVE CONTRACTING......Page 260
OUTCOMES OF STRATEGIC INNOVATION II: COST SHARING......Page 262
OUTCOMES OF STRATEGIC INNOVATION III: MANAGED CARE......Page 265
OUTCOMES OF TACTICAL INNOVATIONS......Page 268
KEY TERMS......Page 271
DISCUSSION QUESTIONS......Page 272
LEARNING OBJECTIVES......Page 273
THE APPEAL OF PREVENTION......Page 274
THE SCIENTIFIC RATIONALE FOR PREVENTION......Page 275
PREVENTION IN PRACTICE......Page 284
CHALLENGES TO PREVENTION......Page 290
DOES PREVENTION SAVE MONEY?......Page 299
THE FUTURE: PREVENTION AND U.S. HEALTH CARE......Page 303
DISCUSSION QUESTIONS......Page 304
LEARNING OBJECTIVES......Page 307
GOVERNMENT AND HEALTH CARE IN THE UNITED STATES......Page 308
GOVERNMENT PARTICIPATION IN HEALTH CARE......Page 312
THE PUBLIC ENVIRONMENT......Page 320
THE MEANING OF PUBLIC POLICY......Page 321
POLITICS: THE DRIVER OF POLICY......Page 322
WINNING AND LOSING IN HEALTH CARE POLITICS: THREE CASE STUDIES......Page 328
LESSONS LEARNED......Page 334
THE CASE AGAINST GOVERNMENT IN HEALTH CARE......Page 336
SUMMARY......Page 338
LEARNING OBJECTIVES......Page 341
OPPORTUNITIES AND BARRIERS TO CHANGE......Page 342
NON-U.S. HEALTH CARE SYSTEMS: CHALLENGES AND LESSONS LEARNED......Page 343
A SYSTEM TO BE EMULATED? CONCERNS ABOUT CANADA......Page 347
STATE-LEVEL INITIATIVES IN THE UNITED STATES......Page 351
RECENT HEALTH CARE REFORM EFFORTS......Page 352
FUTURE CONTROVERSIES AND OPTIONS......Page 354
SUMMARY......Page 356
DISCUSSION QUESTIONS......Page 357
GLOSSARY......Page 359
NOTES......Page 367
INDEX......Page 387